The Sexpert Series: Dr. Patti Britton

When it comes to sex therapy, pretty much anyone with an opinion can hang out a shingle and call themselves an “expert,” but how do you separate the spin doctors from the real deal? In the days ahead, SexIs will be speaking to some of the most respected “sexperts” in the field to separate pros from the poseurs—and get the skinny on how to have great sex.

“America’s Sex Coach,” Dr. Patti Britton, is a nationally board-certified clinical sexologist and world-renowned sex coach. She’s the author of hundreds of articles and four books, a popular speaker, the original “sexpert” for iVillage.com, and host of 35 DVDs about sexuality. Vivacious and outspoken, Britton is a breath of fresh air in a field crowded with talking heads and questionably qualified sex gurus. Here’s what she had to say about getting sound and reliable sex advice.

What should people look for in a sexpert?

I always advise people to find someone who’s lived a little bit of a life. Having life experience and life wisdom is really similar to, “physician, heal thyself.” I find that a person who is authentically a sexual being is really the best bet in terms of who is an expert. That’s why my pet peeve is when someone who is 23 years old is writing an advice column about how to have a great, sustaining, life-long committed hot and spicy relationship.

Just because someone’s had a lot of sex doesn’t mean they are an expert. Someone who says they’ve had a lot of boyfriends or a lot of girlfriends, or someone who says, “I’ve been married 18 times” is a red flag. What astounds me is that most psychologists, therapists, psychotherapists, and even American family counselors have very little, if any, sexuality background and training.

Great question. One is the medicalization of sexuality. Any of us who are consumers know that television is rampant with ads that push pills in the consumer marketplace. The idea that popping a pill will cure all your ills when it comes to sex is bogus. It does not remedy the cause. It certainly addresses symptoms, whether it’s erectile dysfunction or the endless pursuit of the pink female Viagra, or even things as simplistic as if a woman has never experienced an orgasm. Have her just rub a little VapoRub on her clitoris and all will be fine. It’s not.

The second answer is that a sex toy [can’t] always fix a relationship. I’m a huge advocate of allowing couples to learn to embrace and positively regard the addition of sex toys into their sexual experience, their lovemaking techniques, their sexual styles together.

For men who have never learned to control ejaculation, learning how to use a sexual aid such as a penile ring that helps keep the blood flow intact is just exactly what he needs to boost his sexual self-confidence.

Similarly, for women who are non-orgasmic—we in sexology like to regard them as pre-orgasmic—often, a toy can be a wonderful adjunct for sexual behavior to increase pleasure and arousal, and even to create a new pathway in the brain, and the body’s experience. But to rely on a toy instead of the human connection is going to backfire eventually.

It’s been said that people who are “selfish” in bed have better sex lives? True or false?

From a sexology point of view, that to me makes sense. The reason is we have to know ourselves. We have to focus on ourselves first. You have to know your own wants and tastes and desires in order to express that with a partner and be known. So, if a person isn’t selfish or self-directed, they’re going to be at the whim of a partner, as opposed to being a fully present participant in the experience. If you don’t know what it is that turns you on, if you don’t know what it is that helps you get aroused and stay aroused—you can’t possibly rely on someone else to push the right buttons every time. Being selfish is a gateway to having better sex.

Is being selfish one of your “46 Sexually Related Concerns”?

No, “The 46 Sexually Related Concerns” are actually what the consumer would consider to be a problem to solve. Being selfish is not a problem, but actually a method or a technique for resolving your sexual concerns.

Could you talk a bit more about them?

Sure. Do you have about six hours? (laughs)

Okay, just the top ones, male and female.

The most common issues that men report have shifted since 1999 because of the advent of the three drugs: Cialis, Levitra and Viagra. We don’t get many erectile dysfunction patients anymore. Now, ejaculatory issues are very present. Most commonly, we find an early or a rapid ejaculator so much he does not have the ability to control and then whether he releases his ejaculation. The other side of that equation is delayed ejaculation. Delayed ejaculators are often men who have an issue of trust with women and just can’t let go, essentially.

For women, the number one issue (from the 1999 study “Sexual Dysfunction in the United States) is low or hypoactive sexual desire. Women tend to have a much more complex layered structure around desire—including how they feel about their body image; whether there’s repressed anger and resentment in their relationship; exhaustion and fatigue, which is one of the absolute killers of sex drive.

Another common issue for women is an inability to experience an orgasm, either alone or with a partner. Most women who present as clients have the ability to produce an orgasm through masturbation, but not with a partner. In part, it’s because of the misnomer that sexual intercourse (penile/vaginal sex) is an effective means for getting there—and it is not! From a sensory point of view, the clitoris is definitely the main part of the sexual structure for [female] pleasure. Most women—80 to 90 percent—need direct or indirect clitoral stimulation to experience orgasm. Therefore, [traditional intercourse], unless it’s riding on the clitoral body, is a highly ineffective way of producing that orgasm.

You’ve just said that women need clitoral stimulation to have an orgasm, so what do you think of all the publicity about the G-spot?

The G-spot is a different zone of the body. It’s still debated in the field as to whether or not it exists, but I’m absolutely convinced that there is a G-spot and there is female ejaculation. I have many clients who’ve exhibited it.

What complaint do you hear most often from couples?

The most common—and this is in my opinion and my observation, which is shared by many of my renowned colleagues—is the sexless relationship.

By the time the relationship has become sexless, it’s also usually a relationship that is touch-less. [The couple stops] being affectionate. They stop daring to be sensual in any way with each other because there are issues in the relationship and issues in the sexual communication that have really stopped flowing. Those issues are severe enough to actually create a total shut down in the sexual expression in that relationship. Issues such as an affair or boredom or not understanding that [people] change over time in relationships.

What are the health benefits of a fulfilling sex life?

From a relational standpoint, one of the great things about sex is that there are subtle cues that happen during sex. Often, it leads to a greater feeling of intimacy. Sex leads to sharing of a part of ourselves that we choose to share only with certain people by choice.

When we walk around the world as a public person, we show our face, and hands and feet, maybe our legs and our arms. We don’t show the parts that are covered up by the bathing suit. So, when we’re intimate with someone in a sexual way, we reveal parts of ourselves that we only reveal only for a select few people. There’s a sense of specialness, a sense of preciousness, and for many couples, a sense of the sacred.

Even if it’s someone a person meets only once, there can be a sacred union. There can be a transcendence to a spiritual realm of god-like attainment. I love it when couples are willing to let me guide them and take them the distance to working way beyond the mechanical levels of sex to pleasure to spiritual connection to ecstasy.